Exercise cardiac power and the risk of heart failure in men: A population-based follow-up study

Biomarkers of heart failure: advances in omics studies

Heart failure is a complex syndrome characterized by progressive circulatory dysfunction, manifesting clinically as pulmonary and systemic venous congestion, alongside inadequate tissue perfusion. The early identification of HF, particularly at the mild and moderate stages (stages B and C), presents a clinical challenge due to the overlap of signs, symptoms, and natriuretic peptide levels with other cardiorespiratory pathologies. Nonetheless, early detection coupled with timely pharmacological intervention is imperative for enhancing patient outcomes. Advances in high-throughput omics technologies have enabled researchers to analyze patient-derived biofluids and tissues, discovering biomarkers that are sensitive and specific for HF diagnosis. Due to the diversity of HF etiology, it is insufficient to study the diagnostic data of early HF using a single omics technology. This study reviewed the latest progress in genomics, transcriptomics, proteomics, and metabolomics for the identification of HF biomarkers, offering novel insights into the early clinical diagnosis of HF. However, the validity of biomarkers depends on the disease status, intervention time, genetic diversity and comorbidities of the subjects. Moreover, biomarkers lack generalizability in different clinical settings. Hence, it is imperative to conduct multi-center, large-scale and standardized clinical trials to enhance the diagnostic accuracy and utility of HF biomarkers.

Quantitative Evidence of the effect of Baduanjin exercise on quality of life and cardiac function in adults with chronic heart failure

BACKGROUND

This study aimed to assess the effects of Baduanjin exercise on the quality of life (QoL), cardiac function, and maximal oxygen consumption (VO2max) in patients with chronic heart failure (CHF).

METHODS

A systematic search of relevant literature published from inception until February 2023 was performed in the Scopus, PubMed, MEDLINE, CINAHL, Cochrane Library, SPORTDiscus, and China National Knowledge Infrastructure databases. We included randomized controlled trials (RCTs) that examined the effects of Baduanjin exercise on QoL (Minnesota Living with Heart Failure Questionnaire [MLHFQ]), cardiac function (N-terminal B-type natriuretic peptide [NT-Pro BNP] and left ventricular ejection fraction [LVEF]), and VO2max in patients with CHF.

RESULTS

Fifteen studies (1180 participants) were included in this analysis. The synthesized results suggested that Baduanjin exercise contributed to significant improvements in the MLHFQ scores (standard mean difference [SMD] = 1.10, 95% confidence interval [CI]: 0.81 to 1.39, p < 0.001), NT-Pro BNP levels (SMD = 0.62, 95% CI: 0.31 to 0.93, p < 0.01), LVEF (SMD = 0.53, 95% CI: 0.18 to 0.88, p < 0.01), and VO2max (SMD = 0.92, 95% CI: 0.24 to 1.60, p < 0.001) compared with the results of the control groups. Subgroup analyses revealed that engaging in Baduanjin exercise 5-7 times per week was more effective in improving the MLHFQ score compared with 3-4 times per week (p = 0.04).

CONCLUSION

Evidence from the meta-analysis support the beneficial effects of Baduanjin exercise on the QoL, cardiac function, and VO2max in patients with CHFin China. For optimal QoL improvements, it is recommended to engage in Baduanjin exercise 5-7 times per week for 30-60 min, over a duration of at least 8 weeks. In terms of NT-Pro BNP, Baduanjin exercise sessions of 30-60 min, 2-7 times per week, for a minimum of 8 weeks are recommended.

Associations of the serum n-6 PUFA with exercise cardiac power in men

Low intake or tissue concentrations of the n-6 PUFA, especially to the major n-6 PUFA linoleic acid (LA), and low exercise cardiac power (ECP) are both associated with CVD risk. However, associations of the n-6 PUFA with ECP are unknown. The aim of the present study was to explore cross-sectional associations of the serum total n-6 PUFA, LA, arachidonic acid (AA), γ-linolenic acid (GLA) and dihomo-γ-linolenic acid (DGLA) concentrations with ECP and its components. In total, 1685 men aged 42-60 years from the Kuopio Ischaemic Heart Disease Risk Factor Study and free of CVD were included. ANCOVA was used to examine the mean values of ECP (maximal oxygen uptake (VO2max)/maximal systolic blood pressure (SBP)) and its components in quartiles of the serum total and individual n-6 PUFA concentrations. After multivariable adjustments, higher serum total n-6 PUFA concentration was associated with higher ECP and VO2max (for ECP, the extreme-quartile difference was 0·77 ml/mmHg (95 % CI 0·38, 1·16, Pfor trend across quartiles < 0·001) and for VO2max 157 ml/min (95 % CI 85, 230, Pfor trend < 0·001), but not with maximal SBP. Similar associations were observed with serum LA concentration. Higher serum AA concentration was associated with higher ECP but not with VO2max or maximal SBP. The minor serum n-6 PUFA GLA and DGLA were associated with higher maximal SBP during exercise test and DGLA also with higher VO2max but neither with ECP. In conclusion, especially LA concentration was associated with higher ECP. This may provide one mechanism for the cardioprotective properties of, especially, LA.